1. FRED YASSO AND JOHN VAN DER GIEZEN TALKING TO US MOB

2. POPULATION Low population, 2% to 6% (4% in WA) Small communities, self contained cultural life Strong extended families and communities

3. LEGACY OF HISTORY Lived experience in a strong oral culture Stories of oppression Suppression of culture, language and ceremony Removal of children Poverty High unemployment

4. HOME Households with 3 or more generations Keeps stories strong, relevant to now History has a long memory High probability of someone close having been removed (Stolen Generations)

5. CONSEQUENCES TO PHYSICAL AND MENTAL HEALTH Suspicion and fear of government services, particularly law, health and welfare Reluctance to engage Long delays before seeking help A negative impact on health outcomes

6. HEALTH SERVICES TODAY Tend to be facility based Focus on individuals From a cultural perspective, this doesn’t work A brief look at health outcomes confirms this view

7. CONCEPT OF ABORIGINAL HEALTH Aboriginal concepts of mental health are holistic and are defined as follows: “Health does not just mean the physical well-being of the individual but refers to the social, emotional and cultural well- being of the whole community. This is a whole of life view and includes the cyclical concept of life-death-life. Health care services should strive to achieve the state where every individual can achieve their full potential as human beings and thus bring about the total well-being of their communities.” “This is an evolving definition.” Ways Forward - National Aboriginal and Torres Strait Islander Mental Health Policy National Consultancy Report by P. Swan and B. Raphael

8. SERVICES OUTREACH INTO THE COMMUNITY Mobile Adaptable Patient (take your time!) Reliable Demonstrate effectiveness and usefulness CONFIDENTIALITY Results Personality based (not just a nurse, SW)

9. PROVIDING INFORMATION TO COMMUNITY What do services do? How they work? What they can achieve? How to access them? How to understand what’s going on? Must be able to educate out there on the ground Explain in detail how things work rather than assuming people know. Eg; Explain the process of assessment, admission, treatment and about mental health

10. DEVELOPING PARTNERSHIPS Between; Communities and workers/services Workers and families/individuals Services and communities, families, individuals

11. RELATIONSHIPS Build relationships with communities Build relationships with Elders, families Build relationships with individuals (preferably in this order)

12. ABORIGINAL WORKFORCE Engaging and building relationships with Indigenous people is integral to good positive outcomes Indigenous people are an important facet of developing Culturally capable services Indigenous people can provide cultural experience and knowledge to address needs of their community Assist clinicians and other mental health workers to navigate Indigenous Community life (Vice Versa) Provide key ways of working which will increase chances of success